Bell, D S, Bell, K M, Cheney, P R · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 1994 · DOI
This study looked at whether children diagnosed with chronic fatigue syndrome (CFS) also had fibromyalgia, a condition involving widespread muscle pain and tender points. Researchers found that about 30% of children with CFS met the criteria for fibromyalgia, and these children experienced more muscle pain, sleep problems, and neurological symptoms than those without fibromyalgia. The study suggests that CFS and fibromyalgia in children may be closely related or even the same condition.
This study highlights an important clinical overlap between two poorly understood pediatric conditions, suggesting that CFS and fibromyalgia may share common underlying mechanisms in children. Understanding this relationship could improve diagnosis and lead to more targeted treatment approaches for adolescents with these debilitating conditions. For patients, this work emphasizes that multiple symptoms often co-occur and should be evaluated together rather than in isolation.
This study does not establish causation or identify the underlying biological cause of either CFS or fibromyalgia. It does not prove that CFS and fibromyalgia are definitively the same disease—only that they overlap significantly in pediatric populations. The findings are correlational and based on a small sample, so results may not apply broadly to all children with these conditions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bell, D S, Bell, K M, & Cheney, P R (1994). Primary juvenile fibromyalgia syndrome and chronic fatigue syndrome in adolescents.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/clinids/18.supplement_1.s21
BibTeX
@article{mecfsatlas-bell-1994-primary-juvenile,
author = {Bell, D S and Bell, K M and Cheney, P R},
title = {Primary juvenile fibromyalgia syndrome and chronic fatigue syndrome in adolescents.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {1994},
doi = {10.1093/clinids/18.supplement_1.s21},
note = {PubMed: 8148447},
url = {https://www.mecfsatlas.com/evidence/bell-1994-primary-juvenile},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/bell-1994-primary-juvenile
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